HB 185-POSTSECONDARY STUDENT IMMUNIZATION 3:52:53 PM CHAIR WILSON announced that the next order of business would be HOUSE BILL NO. 185 "An Act relating to immunization of postsecondary students for meningitis; and providing for an effective date." ERIC DELAND, Staff to Representative Mike Chenault, presented the sponsor statement for HB 185 on behalf of Representative Chenault. He described how a man in Alaska, age nineteen, was overcome with a meningococcal disease and became brain dead within several hours of the onset of symptoms. He informed that meningococcal disease has a 15 percent mortality rate. What this bill tries to do, he related, is remove the exemption so that post-secondary institutions shall provide information about viral and bacterial meningococcal diseases and their risk. He said that the students shall also sign a document stating that they have received this information and can have the option of immunization. He emphasized that there is no requirement for immunization in HB 185. He said that the Center for Disease Control, the American Academy of Physicians, and the American Academy of Pediatrics recommend immunizations for post-secondary students. CHAIR WILSON commented that immunization requirements concerning meningococcal disease are required for some groups of people but that there are known exemptions. She offered religious beliefs as an example of an exemption. MR. DELAND explained that the passage of HB 185 will enable post-secondary students to receive information about meningococcal disease. He said that post-secondary students live in high-risk environments for the spread of meningococcal disease CHAIR WILSON clarified that this bill does not require immunization of students. MR. DELAND stated that it requires post-secondary schools to provide information pertaining to meningococcal disease and information about immunization. REPRESENTATIVE GARDNER asked if there are various types of meningococcal disease. MR. DELAND said that meningococcal disease can be viral or bacterial. He informed that there are many different strains. REPRESENTATIVE GARDNER inquired as to the effectiveness of the immunization for all of the types of meningococcal disease. MR. DELAND stated that the immunization is effective, regardless of the strain of meningococcal disease. REPRESENTATIVE KOHRING inquired as to the necessity of passing HB 185 and creating statute around this issue. He asked if schools are informed about meningococcal disease. MR. DELAND said that most schools around the country are requiring immunizations but it is not required in Alaska. REPRESENTATIVE KOHRING asked if schools in Alaska know that meningococcal disease is a problem. MR. DELAND opined that schools should know [about meningococcal disease] and the purpose of HB 185 is to provide necessary information so that students can make a decision regarding immunization. REPRESENTATIVE KOHRING inquired as to the distribution of letters to schools as an attempt to inform, as opposed to creating legislation. MR. DELAND clarified that HB 185 is related to post-secondary schools. REPRESENTATIVE KOHRING offered that the letters be distributed to post-secondary schools. He expressed his uncertainty of creating a bill to inform students of a disease. MR. DELAND restated that not all institutions provide information on meningococcal disease. REPRESENTATIVE KOHRING inquired as to the cost associated with the distribution of information. MR. DELAND explained that there is a [health] packet handed out to new students at post-secondary schools and this information would be included in that packet. 3:59:05 PM REPRESENTATIVE MCGUIRE said, "We're requiring that information be given but we're not requiring immunization?" MR. DELAND said that is correct. REPRESENTATIVE MCGUIRE asked why immunization is not required. MR. DELAND said that the reasons are similar to those brought up by Chair Wilson. He described the issues concerning religious beliefs, and opined that each individual should make their own decisions [to immunize]. REPRESENTATIVE MCGUIRE related that, in her experience, immunizations were required when attending school. CHAIR WILSON clarified that there are other exemptions. She commented that some people don't believe in immunizing their children, and that, based on her experience as a school nurse for many years, there are many reasons why people choose not to be immunized. 4:00:35 PM REPRESENTATIVE MCGUIRE inquired as to the number of states that require immunization [of meningococcal disease]. RICHARD MANDSAGER, M.D., Director, Division of Public Health, Department of Health and Social Services, stated that there are two varieties of meningococcal vaccine for this organism, for Neiserria meningitidis. He explained that this is the kind of meningitis that makes people fearful. He said: somebody gets sick with flu symptoms and can be dead in a few hours. Thankfully, it's very rare. There is a small, increased risk if you are a freshman in a college dorm or in the military, and that's where the epidemics back ... during WWII, were first recognized. A couple things have changed this winter, the American Council on Infectious Practices has just changed its recommendations about the vaccine for Neiserria meningitidis ... and is now recommending, because there is a new vaccine available this winter, that all people ... get it ... within a few years, this is going to be common practice for most kids entering post-secondary institutions ... colleges already include it in their information ... we in the [Department of Health and Social Services] are fairly neutral on this bill for some of the reasons that Representative Kohring just stated ... there's a small number of post-graduate colleges in this state and couldn't we persuade them to voluntarily include [a letter] rather than have a statute, given the fact that immunization practices over the next five years, most kids, by the time they go off to college, are going to be immunized already with a new vaccine. Your question is specifically how many states have requirements for either information or vaccination or nothing, most have moved to ... either requiring information or requiring immunization and there's a mixture across the country but it's going to change fairly quickly now with the change in immunization practices. We are a universal immunization state and we don't have to include this vaccine because of the vaccine for kids which is the federal program ... as long as we remain a universal vaccine state, all of our kids in this state will be offered, and the only kids that won't be immunized will be the families that choose not to get vaccinated, but it will get joined into the requirement for school attendance over this next year ... I recognize the ... interest in the bill, but the timing is interesting given the change in vaccine as to how necessary it is, given it's going to happen, anyhow. 4:04:06 PM REPRESENTATIVE MCGUIRE expressed her belief that if [the legislature] makes a fundamental policy shift to require immunizations, then that should be the law created. She inquired as to the requirements of immunizations at the local level for students, before entering school. DR. MANDSAGER said that over this next year, because Alaska is a "universal vaccine state", the Department will be putting up proposed regulations that [meningococcal disease vaccine] will get added to the schools for students in grades K-12. He opined that over the next six months the [meningococcal disease vaccine] will be added in; the [Department of Health and Social Services] will have to put out regulations proposing to amend the mandatory vaccine policies for schools and, if that happens, over the next few years all of the teenagers are going to get vaccinated. REPRESENTATIVE MCGUIRE clarified that the [meningococcal disease vaccine] will be a requirement for students in grades K-12. REPRESENTATIVE SEATON stated that HB 185 deals specifically with post-secondary students. He asked if regulations proposed by the state will apply for post-secondary schools. DR. MANDSAGER said that the state has no authority to regulate immunization in post-secondary schools. REPRESENTATIVE GARDNER inquired as to the document mentioned in HB 185 where the student's immunization status is recorded. She asked how long this document would be kept and by whom. MR. DELAND said that the document would be kept while the student was attending that institution, by the institution. 4:07:18 PM REPRESENTATIVE MCGUIRE moved to report HB 185 out of committee with individual recommendations and the accompanying fiscal notes. REPRESENTATIVE GARDNER objected. She said that if this bill were to pass, she anticipates repealing it when regulations are revised. She said that she is not in favor of passing a bill that may not be needed. CHAIR WILSON reminded Representative Gardner that the new regulations would apply to grades K-12, and HB 185 is dealing with post-secondary schools. A roll call vote was taken. Representatives Anderson, McGuire, Seaton, Cissna, and Wilson voted in favor of reporting HB 185 out of committee. Representative Gardner voted against it. Representative Kohring was absent for the vote. Therefore, HB 185 was reported from the House Health, Education and Social Services Standing Committee by a vote of 5-1. 4:09:52 PM